488
CLINICAL
AND
LABORATORY NOTE
.
[Onad. 7 vA.J. 1 Nov. 1947, vol.57
cases was due solely to the effect of the folic acid.\ One should never be dogmatic under such circumstances. However, clinically there seemed little doubt, particularly in Case 1, because of the marked and almost immediate change in the signs and symptoms, that this treatment was responsible for the amelioration of the condition through rise in the number of platelets. Moreover, there has been no recurrence of symptoms, or return of the thrombocytopenia under continuation of the drug. Neither of these cases, do we feel, is an essential thrombocytoSenia of Werlhof. Case 2 is in all probability secondary to the bismuth therapy and Case 1 is most likely some other idiopathic form of thrombocytopenia with a profound and prolonged paralytic effect on platelet formation. These cases are presented to recommend at least a trial of this drug in cases of persistent heemorrhagic diathesis due to platelet deficiency, and more particularly when this is apparently due to a secondary inhibition of thrombocytogenesis.
CLINICAL and LABORATORY NOTES
REMOVAL OF FOREIGN BODIES IN RECTUM F. H. MacLeod, M.D. Cleveland, Ohio The following method is advanced as a possible aid in removing certain rectal foreign bodies which have no available purchase point for common instruments. This method has been used successfully by me to remove a forty watt household electric' light bulb intact, and a faecal impaction of similar size. The light bulb had been inserted with socket portion entering and an attempt to do a version was unsuccessful. Under ana!sthesia of choice, with patient in lithotomy position, the anal sphincter is dilated digitally to allow entrance of four fingers. An assistant exerts pressure over sigmoid through abdominal wall to help prevent displacement of foreign body into sigmoid. With a guiding index finger in the rectum two large table spoons are applied in manner of obstetrical forceps. The index finger of the left hand is then used to form a joint near the neck of the spoons. A strong steady pull will dilate the sphincter and deliver the foreign body with a minimum amount of trauma.
UNIVERSITY OF TORONTO
Faculty of Medicine
REFRESHER COURSE IN OPHTHALMOLOGY AND OTO-LARYNGOLOGY A refresher course in the combined subjects of practical ophthalmology and oto-laryngology will be held under the auspices of the Faculty of Medicine, January 26th to 31st, 1948. The course will be so arranged that the operative procedures and bedside conferences of the one specialty will be held in the morning and the didactic conferences pr lectures in the afternoons. The reverse of this-procedure in the other specialty will rriake it possible to pick whatever subjects. may be of interest to each applicant. A full programme will be published later and will also be available on application to the Medical Office, University of Toronto. The fee for the the course is $50.00. The course will be given for a minimum of 10 students and a maximum of 20 students. No Applications Received After November 30th